Training Program
                                               Training Program

 The Methodist Hospital’s ...
Level 2 hood is available for gene therapy and/or stem cell implantation         ATTENDING
procedures. Ongoing projects in...
FIRST YEAR (NS-1)                                                       THIRD YEAR (NS-3):
The first year at The Methodist ...
The Methodist Hospital System is a nonprofit health care ...
At 8,778 square miles, the Greater Houston area covers more ground than any other major
city in America. In...
ABOUT THE TEXAS MEDICAL CENTER                                       throughout Houston and the surrounding communities, a...
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Training Program

  2. 2. NEUROLOGICAL SURGERY RESIDENCY Training Program The Methodist Hospital’s Department of Neurosurgery is an integral part of The Methodist Neurological Institute. The residency program in Neurological Surgery was accredited by the ACGME in July 2005. The goal of the training program is to develop the intellectual, technical, and professional competencies of the residents, and to prepare them for their future careers in practice and in research. We are interested in training neurosurgeons for both academic and practice settings. The Neurological Institute has a faculty with a broad range of subspecialty experience, extensive facilities, and is located in a city whose metropolitan area has a population of over five million people. Over 3,500 major neurosurgical procedures and 400 interventional neuroradiological procedures were performed at the Neurological Institute in the past year. The Institute currently has a staff of 13 neurosurgeons, 8 neurologists, and 10 neuroradiologists. O R G A N I Z AT I O N The Methodist Hospital Residency in Neurological Surgery is a six-year program after the year of general surgery training, through which one resident each year matriculates. Application to the program is made through correspondence with the Central Application Service and David S. Baskin, M.D, the Program Director. Completed applications, transcripts, letters of recommendation, etc., are forwarded by the application service to the Office of the Program Director. Applications are reviewed and interviews are conducted by the active teaching staff. TRAINING PLAN The training plan is directed towards the goal of providing the resident with the core knowledge and experience necessary to graduate as a competent neurological surgeon. The plan is further directed towards preparing the resident for successful examination by the American Board of Neurological Surgery. RESEARCH Each resident is expected to develop and complete a clinical or basic research project during the research year described below. Ample research opportunities are available to the resident at the Methodist Hospital, and via numerous collaborations throughout the Medical Center. The department will have almost 4,000 square feet of research space available in January of 2006, including wet lab space with state of the art molecular biology capabilities, as well as an experimental surgery operating room for developing microsurgery skills, neuroanatomy dissections, and sterile surgery. A Bio Containment
  3. 3. Level 2 hood is available for gene therapy and/or stem cell implantation ATTENDING procedures. Ongoing projects include work with glioblastomas, experimental stroke and spinal cord injury, and nanotechnology using nano-machines and PHYSICIANS nanotubes with specific labels attached. In addition, there is space available with state-of-the-art radiological equipment for vascular neurosurgery research in conjunction with Neuroradiology. Yet another laboratory TEAM A experience is available in spinal cord injury and regeneration at the Methodist Hospital, through collaborations with the Christopher Reeve James Rose, M.D. Paralysis Foundation. Todd Trask, M.D. David Baskin, M.D. In addition, the Department has affiliations with the University of Houston, which has an extensive research program with interests in neuro-engineering, Robert G. Grossman, M.D. frameless navigation, and MR imaging, including spectroscopy, diffusion Richard Harper, M.D. tensor imaging, and functional MRI imaging. There are also interests in David Cech, M.D. developing artificial intelligence via novel computer programs and simulations. SUMMARY OF THE METHODIST H O S P I TA L TEAM B NEUROSURGERY RESIDENCY PR O G R A M The service at the Methodist Hospital is divided into two teams for the J. Bob Blacklock, M.D. educational purposes, and for efficient care by subspecialty areas. Team A Daniel Yoshor, M.D. predominantly performs vascular, brain tumor, skull base, and radiosurgery. Rob Parrrish, M.D., Ph.D. Team B predominantly performs epilepsy, functional, complex spine surgery, and peripheral nerve surgery. Both teams perform simple spine Richard Simpson, M.D., Ph.D. surgery. Attendings on one team may perform a type of surgery predominantly Al Aldama, M.D. performed by the other team. In such instances, residents will continue to Bruce Ehni, M.D. work with the attendings on their team. Warren Parker, M.D.
  4. 4. FIRST YEAR (NS-1) THIRD YEAR (NS-3): The first year at The Methodist Hospital provides the resident At The Methodist Hospital, the NS-3 resident performs more with an in-depth overview of neurological history taking and advanced procedures and assumes more administrative duties. physical examination, the spectrum of neurosurgical disease, The resident spends 6 months with the faculty of the Team A the indications and contraindications for surgery, management and 6 months with Team B. of critically ill patients in an intensive care setting, and an overview of operative techniques. The NS-1 resident spends The resident is expected to plan a research project that will 6 months on each team. The first-year neurosurgical resident continue into the fourth year. operates on a wide variety of cases with the attending physicians and is responsible for the care of patients in the neurosurgical The NS-3 resident plans the morning clinical conferences at intensive care unit with the assistance of the NS-3 resident, The Methodist Hospital. At the end of the year of training, the under the supervision of the chief resident and the attending resident should be able to be the primary surgeon on the most physicians. Experience in the neurosurgery intensive care unit standard neurosurgical procedures. occurs throughout the year under the direction of Dr. Todd Trask, Medical Director of the NICU, as well as by interactions FOURTH YEAR (NS-4) with consultants. The NS4 year is dedicated to laboratory or clinical research without interruption for call responsibilities. The resident can By the end of the first year, the resident has acquired skill in work in one of the laboratories in the department or elsewhere. the work-up and management of patients and the recognition of Financial support for this year includes salary. If the resident is preoperative and post-operative problems, is familiar with most located away from Houston, The Methodist Hospital will cover neurosurgical procedures, and is competent to manage critically the resident’s travel and room and board expenses. ill patients in an ICU setting. The resident will be able to perform ventriculostomies, place lumbar drains, open and close During this time, the resident may continue a project started in craniotomies, perform peripheral nerve explorations, and perform the NS-2 and NS-3 years. Our experience has shown that, by decompressive lumbar laminectomies. initiating projects in already functioning laboratories, the residents are able to complete research projects in the areas of intracranial SECOND YEAR (NS-2) pressure and blood flow analysis, ischemia protection, brain tumor During the second year, the resident refines diagnostic, clinical, and biology and treatment, and gene therapy for brain tumors. Support laboratory skills during rotations on the neurology, neuroradiology, is available for study design, biostatistical, and manuscript and/or and neuropathology services. Second-year residents should also poster presentation. Residents are expected to submit a minimum identify a research project for their research year, in consultation of one manuscript to the neurosurgical journal and an abstract to with the Program Director. the neurosurgical meeting during the fourth year. The rotation in Neurology refines the resident’s history-taking and FIFTH YEAR (NS-5): physical examination skills, exposes the resident to comprehensive The year is divided into three 4-month blocks. During one of inpatient and outpatient management of neurologic disease these times, the resident will spend 4 months in Pediatric including the use of electrophysiology, and helps to develop the Neurosurgery at New York Presbyterian Hospital. The resident resident’s judgment in the selection of cases for surgery. Each will work closely with the full-time faculty and will have operative resident spends 4 months on the Neurology service. Rotations responsibility for a wide variety of pediatric neurosurgical cases. for TMH residents are at the Memorial Hermann Hospital The resident will also work closely with the neuroradiology, under the direction of Dr. James Ferrendelli, Chairman of the neuropathology, and neurology services. Expenses including travel Department of Neurology at The University of Texas Medical and housing will be paid for by the residency training program. School at Houston, and at the Methodist Hospital under the direction of Dr. Stanley Appel, Chairman of the Department The other 8 months will consist of enfolded subspecialty experiences of Neurology at the Methodist Hospital. Neurology residents at The Methodist Hospital, in two 4-month blocks. The resident from the University of Texas Medical School at Houston will can select two rotations from the following subspecialties: Vascular; rotate at the Methodist Hospital starting in July 2005. Both brain tumors and radiosurgery; complex spine; stereotactic, neurology services are outstanding in the diagnosis and functional, and epilepsy; or interventional neuroradiology. management of epilepsy and stroke, areas of great importance to neurosurgical treating. SIXTH YEAR (NS-6): The last year of training is spent as chief resident at The Methodist On the Neuropathology rotation at The Methodist Hospital, Hospital. The chief resident has administrative responsibility the resident has primary responsibility for the initial reading of for supervising senior and junior residents and medical students, frozen and permanent sections and participates in brain cutting. scheduling all activities of the Neurosurgical Service, and for The resident works closely with Dr. Suzanne Powell, Program organizing the clinical and basic material presented at the conferences, Director of Pathology Residency Training Program at The including tracking and presentation of morbidity and mortality. Methodist Hospital. Residents learn contemporary techniques for analyzing tissues. The chief resident performs all major surgery under the supervision of the attending staff. There will be a chief resident service On the Neuroradiology rotation, the resident is exposed to established with appropriate attending supervision for uninsured myelograms, interventional neuroradiology, kyphoplasties, and patients, which the hospital will support. vertebroplasties. Residents also participate in the daily reading of diagnostic imaging studies. During this year as well as in the previous years, the resident has experience in the subspecialty areas of neurosurgery.
  5. 5. GENERAL INFORMATION THE METHODIST HOSPITAL THE METHODIST HOSPITAL The Methodist Hospital System is a nonprofit health care organization based in Houston, Texas. It has extended the world-renowned clinical and service excellence of its founding entity, The Methodist Hospital, through a network of community- based hospitals. Affiliated with the Texas Annual Conference of the United Methodist Church, The Methodist Hospital system works closely with local church leaders to bring compassion and spirituality to all of its endeavors and to help meet the health needs of the community it serves. A legacy of medical milestones has attracted patients from around the world to Methodist for more than 80 years. In 1996, The Methodist Hospital System was established to extend TMH’s health services beyond the Texas Medical Center and into communities throughout Houston. Its international physician referral network—with information centers in Guatemala City and Mexico City and medical affiliations with hospitals spanning four continents—has extended the Methodist reach into the world community as well. Hospitals: The Methodist Hospital, Houston Methodist Sugar Land Hospital, Sugar Land Methodist Willowbrook Hospital, Houston San Jacinto Methodist Hospital, Baytown Corporate Financial Information (2003): $1.09 billion in net patient revenue $296 million in uncompensated charity care and community benefit activities AA bond rating The Methodist Hospital is affiliated with the Weill Medical College of Cornell University and New York-Presbyterian Hospital, two of the nation’s leading centers for medical education and research. Methodist is also affiliated with The Menninger Clinic, a national specialty psychiatric and behavioral hospital, ranked as one of “America’s Best Hospitals.” Methodist is named among the country’s top hospitals for neurology and neurosurgery; heart and heart surgery; urology; ear, nose and throat; psychiatry; ophthalmology; and gynecology in U.S. News and World Report’s 2005 annual guide to “America’s Best Hospitals.” In addition, the hospital is consistently ranked as most preferred by National Research Corporation’s annual public opinion survey. Methodist’s medical staff includes hundreds of physicians listed in The Best Doctors in America who, along with other health professionals, offer expert preventive services, diagnosis, treatment and follow-up care in virtually every medical specialty. The Methodist Hospital System has been recognized by Hospitals and Health Networks as one of health care’s “100 Most Wired” for its use of Internet technologies to connect with patients, physicians and nurses, employees, suppliers, and health plans.
  6. 6. HOUSTON, TEXAS At 8,778 square miles, the Greater Houston area covers more ground than any other major city in America. In fact, we’re as big as the entire countries of Israel and El Salvador. Most of the communities here spotlight the beauty of Houston, made possible by its proximity to several waterways. Called the Bayou City, Houston is home to more than 10 of these winding waterways that not only irrigate the lush landscape, but also serve as green spaces for fitness and nature enthusiasts. Several lakes and bays also provide pleasant scenes of fun in the sun as well as a feast for the eyes. Beyond beauty, it’s the business opportunities provided by Houston’s waterways that are the primary reasons for the city’s existence. The Port of Houston still thrives today, thanks to the dredging of Buffalo Bayou to form the famous Houston Ship Channel. The port area is just one of the many business districts that have branched out from the inner city. Other areas such as the Uptown/Galleria area, Greenway Plaza, Interstate 10’s Energy Corridor and, of course, the Texas Medical Center, are booming with business development and shortening the commute for many Houston residents. But public transportation and Houston’s excellent freeway system can still connect Houston’s 3 million-plus people to our revitalized downtown business district. Houston’s strong economy has brought with it a diverse population, which has worked to enhance our high standards of excellence in two critical areas—education and worship. The Houston area consistently leads all of Texas in the number of exemplary schools, and because of our cultural diversity, the Houston Independent School District—just one of the many districts in the area—serves students who speak dozens of languages. The international city is also home to 45 religions, from African Methodist to Zoroastrian. For all the far-reaching influences brought together in Houston, our neighbors still share a common goal—the quality of life found in close-knit communities located within one metropolitan melting pot.
  7. 7. ABOUT THE TEXAS MEDICAL CENTER throughout Houston and the surrounding communities, and even in other parts of Texas and the world. The Methodist Hospital is an integral part of the Texas Medical Center, and facilities in the Center are available to Residents in In the Texas Medical Center, there is something to meet every- the Neurological Training Program. body’s needs. The county’s two trauma facilities are located in the center, as are institutions specializing in every imaginable aspect of The Texas Medical Center started with a dream to create a health care, including care for children, cancer patients, heart care, medical center, where people from all walks of life could have organ transplantation, terminal illness, mental health, and wellness access to the best health care anywhere - whether they were rich, and prevention. poor, famous, alone, young, or old. All 42 of the Texas Medical Center’s member institutions are In the more than 50 years since that dream originated, it has not-for-profit, and are dedicated to the highest standards of been realized many times over. The Texas Medical Center today patient and preventive care, research, education, and local, has 42 member institutions that each exists to serve all of man- national, and international community well-being. These kind. On any given day, one can find people from every social institutions include 13 renowned hospitals and two specialty circumstance and many of the world’s nations seeking treatment institutions, two medical schools, four nursing schools, and at the center’s renowned institutions. schools of dentistry, public health, pharmacy, and virtually all health-related careers. It is where one of the first, and still the Many of the member institutions are working to make the Texas largest, air emergency service was created; a very successful Medical Center quality of care convenient to even more people inter-institutional transplant program was developed; and more by putting clinics, offices, and other facilities in neighborhoods heart surgeries are performed than anywhere else in the world.